Renal iron load in sickle cell disease is influenced by severity of haemolysis

TY - JOUR

T1 - Renal iron load in sickle cell disease is influenced by severity of haemolysis

AU - Vasavda, Nisha

AU - Gutiérrez, Lucía

AU - House, Michael J

AU - Drasar, Emma

AU - St Pierre, Tim G

AU - Thein, Swee L

PY - 2012/6

Y1 - 2012/6

N2 - Spin density projection-assisted R2-magnetic resonance imaging (R2-MRI; FerriScan(®)) scans from 40 chelation-naïve sickle cell patients were used to assess renal iron load by measuring renal R2 (R-R2). Clinical data were collected retrospectively for the 2-year period preceding the scan. R-R2 showed no significant correlation with transfusional iron load (assessed by liver iron concentration), but correlated significantly with serum bilirubin (R = 0·61, P <0·0001) and lactate dehydrogenase (R = 0·58, P <0·0001). Mean (±standard deviation) R-R2 was higher (P = 0·02) in patients with renal hyperfiltration (29·8 ± 10·3/s) than those without (23·11 ± 6·6/s). Five patients had significantly lower signal intensity in the renal cortex, as compared to the medulla. These patients had a significantly higher (P <0·0001) mean R-R2 than those showing no cortico-medullary difference. We postulate that the increased R-R2 is associated with haemolysis rather than transfusional iron load in sickle cell disease.

AB - Spin density projection-assisted R2-magnetic resonance imaging (R2-MRI; FerriScan(®)) scans from 40 chelation-naïve sickle cell patients were used to assess renal iron load by measuring renal R2 (R-R2). Clinical data were collected retrospectively for the 2-year period preceding the scan. R-R2 showed no significant correlation with transfusional iron load (assessed by liver iron concentration), but correlated significantly with serum bilirubin (R = 0·61, P <0·0001) and lactate dehydrogenase (R = 0·58, P <0·0001). Mean (±standard deviation) R-R2 was higher (P = 0·02) in patients with renal hyperfiltration (29·8 ± 10·3/s) than those without (23·11 ± 6·6/s). Five patients had significantly lower signal intensity in the renal cortex, as compared to the medulla. These patients had a significantly higher (P <0·0001) mean R-R2 than those showing no cortico-medullary difference. We postulate that the increased R-R2 is associated with haemolysis rather than transfusional iron load in sickle cell disease.

U2 - 10.1111/j.1365-2141.2012.09093.x

DO - 10.1111/j.1365-2141.2012.09093.x

M3 - Article

C2 - 22409346

SN - 0007-1048

VL - 157

SP - 599

EP - 605

JO - British Journal of Haematology

JF - British Journal of Haematology

IS - 5

ER -